Foetal atrial flutter with hydrops in a triplet pregnancy

Abstract

We present a case of atrial flutter with a 2:1 block, associated with hydrops in one fetus of a triplet pregnancy, detected for a foetal tachycardia and confirmed by ecocardrography at 26 weeks of gestation. Digoxin was administered to the mother without success; flecainide was added on the 13^th day of treatment, converting the arrythmia into sinus rhythm with resolution of the hydrops in utero. We discuss the utility of flecainide as a first line treatment and the need for postnatal antiarrythmic prophylactic, considering the favorable out come during this period.